HomeMy WebLinkAbout07-09-07 (8)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG, PA 17128-0601
*'
FILE
ACN
DATE
NO. 21 tf\ o\o~3
07127707
06-20-2007
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REV-1543 EX AFP (09-00>
TYPE OF ACCOUNT
EST. OF FLORENCE S MONTIJO 0 SAVINGS
5.5. NO. 183-16-9805 ,....., 0 CHECKING
~~~~F DEA~UM:~;~~~07 ~ '.Cf\:~ ::~~:F.
REHI;~~~T A~FoR~Sra;~
REGISTER e'~Ilij;LLS I rij ;-fl
CUMBERLANn:~OUrt'P HOItSf-::J
CARLISLE,-':'P~d 70~ C") C)
;0., :x _.~ 33
)c .. C)
- ::0 N rf)
--I ..
12 .r::-
LINDA C BEATY
205 W MAIN ST
SHIREMANSTOWN PA 17011
PSECU has provided the Department with the inforMation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this inforMation is incorrect, please obtain written correction frOM the financial institution, attach a copy
to this forM and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COMMonwealth
of Pennsylvania. Questions May be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0183169805
Date
Established
09-22-1999
To insure proper credit to your account. two
(2) copies of this notice Must aCCOMPany your
paYMent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
13,678.10
50.000
NOTE: If tax paYMents are Made within three
6,839.05 (3) Months of the decedent's data of death,
.045 you May deduct a 5% discount of the tax due.
~ny inheritance tax due will beCOMe delinquent
307 . 76.- 5t1Jo -=292- 3~ine (9) Months aftar the data of death.
x
PART
[!]
TAXPAYER RESPONSE
A. ~ The above inforMation and tax due is correct.
1. You May choose to reMit paYMent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you May check box "A" and return this notice to the Register of
Wills and an official assessMent will be issued by the PA DepartMent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
8. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. [] The above inforMation is incorrect andlor debts and deductions were paid by you.
You MUSt COMPlete PART ~ andlor PART ~ below.
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PART
~
TAX RETURN - COMPUTATION
If you indicate a different tax rate, please state your
relationship to decedent:
LINE l. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART DEBTS AND DEDUCTIONS CLAIMED
[!]
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
.
facts
TOTAL (Enter on Line 5 of Tax Computation)
have reported abov~ Jre true, correct and
HOME (7/7 )7.5/ -7l47~
WORK () c;f-----.:.1
TI=I I=p~nNI= NIIMRI=~ nAT